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Impact of bleeding events after percutaneous coronary intervention in patients on hemodialysis

Takahiro Hayashi1, Koki Shishido2, Shohei Yokota1

  • 1Department of Cardiology, Shonan Kamakura General Hospital, Okamoto 1370-1, Kamakura, 247-8533, Japan.

Heart and Vessels
|April 17, 2020
PubMed

Insights

Bleeding events after percutaneous coronary intervention (PCI) significantly increase mortality in hemodialysis patients. This study highlights the critical link between post-PCI bleeding and survival in this vulnerable population.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Research

Background:

  • Coronary artery disease (CAD) is prevalent in patients undergoing hemodialysis.
  • Percutaneous coronary intervention (PCI) is a common treatment for CAD, but carries a high risk of bleeding in dialysis patients.

Purpose of the Study:

  • To investigate the impact of bleeding events following PCI on all-cause mortality in patients on hemodialysis.
  • To analyze the association between bleeding complications and survival rates after PCI with drug-eluting stents (DES).

Main Methods:

  • A retrospective study of 386 hemodialysis patients who underwent PCI with DES between 2004 and 2017.
  • Assessment of bleeding events using the Thrombolysis in Myocardial Infarction (TIMI) bleeding definition within 24 months post-PCI.
  • Comparison of mortality rates between patients with and without bleeding events.

Main Results:

  • A total of 42 patients (10.9%) experienced bleeding events, with 71.4% classified as TIMI major bleeding.
  • Patients with bleeding events exhibited significantly higher all-cause mortality (survival rate 55.1%) compared to those without bleeding events (survival rate 81.5%).
  • The log-rank test indicated a statistically significant difference in survival (p < 0.001).

Conclusions:

  • Bleeding events occurring after PCI with DES are strongly associated with increased all-cause mortality in hemodialysis patients.
  • This study provides novel insights into the significant relationship between bleeding complications and mortality specifically within the hemodialysis population.
  • The findings underscore the importance of managing bleeding risk in dialysis patients undergoing PCI.

Keywords:
Bleeding eventsHemodialysisPercutaneous coronary intervention

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